This essay appears in today’s edition of the Coins2Day Brainstorm Health Daily. Get it delivered straight to your inbox.
Over the past week or so, I’ve read, watched, and listened to two dozen smart, well-reported stories about cancer—tales of biological mysteries, crusading patients, the challenges of survivorship, and the newly seen quantum effects of an age-old treatment.
As much as journalists themselves may feel frustrated by the “state of journalism” these days, this particular journalist feels pretty darn good about the submissions to the cancer journalism contest I’m helping to judge Friday in Philly.
But while it’s too early to spotlight this year’s best in class, this is a fine opportunity to call out some previous investigative reporting in the cancer arena. And these stories, without a doubt, saved lives.
The articles, in late 2013 and throughout 2014, probed the dangers of a device called a laparoscopic power morcellator—which, for years, had been used to grind up uterine fibroids and make them easier to remove. In December 2013, Jennifer Levitz of the Wall Street Journal broke the news that several Boston area doctors were concerned about the procedure, worrying that it could spread hidden cancers by dislodging malignant cells in or near the benign fibroid tissue in the abdomen and essentially “seed” them in other parts of the body.
At the time, the morcellation procedure was used in an estimated 11% or more of the roughly 500,000 hysterectomies performed annually, the Journal reported—and the American Congress of Obstetricians and Gynecologists considered it “low-risk.”
Yesterday, the Government Accountability Office, an investigative agency of Congress, cited the Journal’s sleuthing in an analysis that, rather gently, faults hospitals and doctors for not reporting to the FDA cases in which women’s cancers were spread after morcellation. But the bigger culprit, they found, is the very passive, volunteer system we have for reporting adverse events—one in which the rules regarding medical devices are particularly murky. (Here’s the summary, but the full report has some eye-opening nuggets and is worth reading.)
The GAO, for example, points to a 2012 study that reviewed 1,091 cases of uterine morcellation at one hospital, reporting “that the rate of unsuspected cancer (uterine sarcoma) after laparoscopic morcellation was 9 times higher than the rate quoted to patients at the time (1 in 10,000).” The study concluded that uterine morcellation carried “a risk of spreading unsuspected cancer.” But no one, it seems, reported the specific cases to the FDA.
The bottom line is that hundreds of thousands of women, over a number of years, went through a procedure that was far more dangerous than they were led to believe. Experts in the field appeared to know that. The government’s watchdog, however, was none the wiser.